Iron Deficiency Anemia

Pathophysiology and Symptoms

IDA can be a primary condition due to blood loss or inadequate iron intake. It may also be a secondary condition due to a disease process or conditions that deplete iron stores, such as GI bleed or pregnancy. In either case, IDA will manifest itself as a microcytic, hypochromic process, where the red cells are small and deficient in hemoglobin (Table 5.5). The CBC will be characterized by a low red count, hemoglobin, hemat-ocrit, MCV and MCHC. The development of IDA is a three-stage process:

• Stage I: Continuum of iron depletion from the marrow (Prussian blue stain will show absence of iron)

• Stage II: Iron deficient erythropoiesis

• Stage III: Finally, a frank case of IDA in the peripheral circulation

In most cases, the patient will not present with overt symptoms until anemia develops (stage III); however, serum ferritin will be decreased at every stage. Diagnostic laboratory tests such as serum iron and serum ferritin may be used by the physician to diagnose an individual well before anemia develops. Individuals in high-risk groups should be periodically monitored for iron status (Table 5.6).

Table 5.3

Inhibitors of Iron

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